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NHS ‘efficiency’ plans for sector ‘sent a chill’ through pharmacists

Sandra Gidley gave a "cautious welcome" to the NHS's long-term plan
Sandra Gidley gave a "cautious welcome" to the NHS's long-term plan

NHS England’s pledge to make efficiencies will have concerned pharmacists, despite its references to expanding the sector's role, a RPS chair has said.

In its long-awaited long-term plan, published yesterday (January 7), NHS England said it aim­­s to “explore further efficiencies” in community pharmacy, by reforming the sector's “reimbursement and wider supply arrangements”.

Royal Pharmaceutical Society (RPS) English board chair Sandra Gidley told C+D the “big concern” regarding what these efficiencies could mean in practice “must be sending a chill through every community pharmacist”.

“The fact [NHS England] is mentioning it at all drives me to think it's not going to be good,” she said.

“It’s very worrying, because a big thrust [of the plan] is talking about prevention, and community pharmacy is in a fantastic position to deliver some of that. But there isn’t much mention of [the sector] in that context.”

NHS England said it would make “reforms to the payment system” across all NHS organisations, by moving “funding away from activity-based payments and ensure a majority of funding is population-based”. However, it did not specify if community pharmacy would be affected by these reforms.

Ms Gidley said the efficiencies “could be linked” to this funding move, alongside NHS England’s plan to fund “community multidisciplinary teams”.

PSNC unsure what efficiencies government wants

The Pharmaceutical Services Negotiating Committee (PSNC) told C+D that it “did not yet know the government’s view on ‘further efficiencies’”.

“We hope this is an indication that they are ready to talk about finding ways to free up community pharmacists’ time so that they can focus more on patient care and delivering new services, rather than dispensing medicines,” PSNC chief executive Simon Dukes said.

RPS: “Cautious welcome” to the plan

In its document, NHS England also said it plans to make “greater use of community pharmacists’ skills and opportunities to engage patients”.

This includes working with community pharmacists to test patients for “high-risk conditions” such as high blood pressure, to offer medicines reviews and inhaler advice to patients with respiratory disease, the creation of “pharmacy connection schemes”, and NHS 111 referrals to pharmacies that support urgent care.

Ms Gidley gave a “cautious welcome” to the “broader sphere” of the plan, as it was “good to see pharmacists in all settings mentioned”.

“We need to be thinking smarter about community pharmacists' role for monitoring long-term conditions [and] taking pressure off GP surgeries,” she added.

What do you make of NHS England's plan?

Leon The Apothecary, Student

Is FMD efficient? 

Lucky Ex-Boots Slave, Primary care pharmacist

Efficieny plans = More funding cuts = More staff and resources cuts = More stress

Just a good way of saying it.

RIP community sector you will be missed.

John Ellis, Community pharmacist

The NHS simply does not want to fund local pharmacies anymore. I suspect that in the near future, people wanting prescriptions dispensed locally, would probably have to see a non-nhs based pharmacy and pay privately for the medicines. This is what has been happening in every other area of the failing NHS, you can't get a scan in time, attend a private clinic, you can't see a GP, go online and get a private consultation, it almost seems like this was the plan all along.

Leon The Apothecary, Student

It sounding more and more like pharmacies are going to see more guiding towards automation.

Reeyah H, Community pharmacist

As for RPS, I don’t want to take off any more pressure from the GPs. We want someone to take the pressure off US, so we can do our job properly. Financial pressure for a start!!!!

Reeyah H, Community pharmacist

PSNC comment is abs appalling. ‘Free up pharmacists’ time’. Guess what? There’ll be a lot of us with free time when no community pharmacy is left standing!!

Tien On, Community pharmacist

Planned obsolescence, just like Apple product upgrade cycles. Aldi style till service (10 deep, one check out); then full on automation/vending machine dispensing .

"free up community pharmacists’ time so that they can focus more on patient care and delivering new services"

A good sentiment from the PSNC but not reality in most cases. Offering services brings in a tiny proportion of income to most pharmacies compared to dispensing medication. I offer full sexual health service, needle exchange, supervised consumption and smoking cessation under nhs service agreements. They are busy services that take up a lot of time and effort. But the income they generate is small in the grand scheme of things.

Unless the funding for these services improves why would pharmacists want to spend less time dispensing/checking if that generates the most income? If a pharmacist wants to spend less time in the dispensary they or their employer need to invest in staff to take away the need for them to be in the dispensary. As rewarding as it would be to be patient focused it can't be done for nothing.

Clarke Kent, Community pharmacist

Sent more than a chill through me. I had to change underwear...

Tien On, Community pharmacist

Not a pants on fire scenario then :)

Nitin Makadia, Pharmacist Director

The involment of pharmacy across all sectors, integration across primary & secondary care and digital advances are great news and nothing short of what pharmacy can and often already delivers. The concern is in the funding model that is available. What is not acceptable is for Community Pharmacy to be stripped of a significant amount of funding in the name of efficiency and then made to feel grateful when some of it is offered back to provide these extra services.

Chris Locum, Locum pharmacist

Unfortunately, the community pharmacy sector will be financially 'plucked' to shore up the costs elsewhere.

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